Title

Author

Publication Date

6-25-2010

Abstract

This study examined the relationship between abstinence self-efficacy (ASE), depression, psychological distress and treatment outcomes in 18 to 24 year olds with substance dependence. Three hundred and three participants completed questionnaires and interviews at three time points during a 28-day twelve-step based inpatient program, and at 1-month and 3-months post-discharge. ASE was measured with the Alcohol and Drug Use Self-Efficacy scale; psychological distress was assessed with the Brief Symptom Inventory 18; and depression diagnoses were determined from the Structured Clinical Interview for the DSM-IV. We tested the association between intake ASE, distress, and depression. Random coefficient regression analyses focused on changes in ASE during and after treatment, with distress and depression included as moderators. We used distress and depression to predict post-treatment outcomes using ordinary least squares regression. At intake, individuals with depression and high distress had significantly lower ASE. During treatment, depression and distress did not moderate changes in ASE, although individuals with depression and high distress had consistently lower ASE throughout treatment. Depression and distress did not predict treatment outcomes, in part because of invariability in 1- and 3-month outcomes. Post-treatment, ASE did not change in a consistent manner, and changes for the most part were not moderated by depression or distress. Among the abstinent, changes in post-treatment ASE did depend on distress, in that those with above average distress at end of treatment increased in ASE from end of treatment to the 3-month follow-up. ASE is a potential byproduct of 12-step based treatment, but on the whole does not behave differently for the depressed versus non-depressed.